Provider Demographics
NPI:1689870560
Name:INTERNAL MEDICINE AND INFECTIOUS DISEASES INC.
Entity Type:Organization
Organization Name:INTERNAL MEDICINE AND INFECTIOUS DISEASES INC.
Other - Org Name:IMID
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:PIEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-597-8765
Mailing Address - Street 1:1010 S KING ST
Mailing Address - Street 2:SUITE 111
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1701
Mailing Address - Country:US
Mailing Address - Phone:808-597-8765
Mailing Address - Fax:808-597-6578
Practice Address - Street 1:1010 S KING ST
Practice Address - Street 2:SUITE 111
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1701
Practice Address - Country:US
Practice Address - Phone:808-597-8765
Practice Address - Fax:808-597-6578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD2401173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIC98590Medicare UPIN